Deep sclerectomy with a collagen implant using the excimer laser

We describe a new technique of nonpenetrating glaucoma surgery that uses the excimer laser to reduce the risk of perforating the trabeculo-Descemet's membrane. With this technique, the ablation is precise and homogeneous. A collagen device is sutured over the scleral bed to create an outflow pathway for aqueous humor drainage. After a superficial scleral flap is dissected with a diamond knife, the sclera, under direct visualization, is ablated with the excimer laser over Schlemm's canal until aqueous humor percolates through from the anterior chamber. A collagen device is placed over the sclera to allow the aqueous humor to flow from the anterior chamber through the trabeculo-Descemet's membrane. The preliminary results show a drop in intraocular pressure to the middle teens.